Is Zero Ventilator-Associated Pneumonia Achievable?: Practical Approaches to Ventilator-Associated Pneumonia Prevention

Abstract

Ventilator-associated pneumonia (VAP) remains a significant clinical entity with reported incidence rates of 7% to 15%. Given the considerable adverse consequences associated with this infection, VAP prevention became a core measure required in most US hospitals. Many institutions implemented effective VAP prevention bundles that combined head of bed elevation, hand hygiene, chlorhexidine oral care, and subglottic drainage. More recently, spontaneous breathing and awakening trials have consistently been shown to shorten the duration of mechanical ventilation and secondarily reduce the occurrence of VAP. More recent data question the overall positive impact of prevention bundles, including some of their core component interventions.

Keywords: Antimicrobial resistance; Chlorhexidine; Prevention bundle; Selective digestive decontamination; Ventilator-associated pneumonia.